And that’s this funky swath from the Upper Midwest, beginning in West Virginia and then into the Deep South and even some of the lower Midwest. The U.S. News and World report looks at these 12 states — Missouri, Oklahoma, Tennessee, Arkansas, Mississippi, Alabama, Indiana, Ohio, Michigan, West Virginia and Kentucky.

Two of these states — West Virginia and Kentucky — have the highest smoking rates in the country at over 24 percent. By comparison, the national smoking rate is roughly 16 percent. Every single one of those 12 continguous states has a smoking rate over 20 percent.

From the article:

Adult smoking rates in “Tobacco Nation” parallel those in some of the most tobacco-heavy countries in the world, including the Philippines (23 percent), China (28 percent) and Indonesia (the highest rate at 35 percent). The high smoking rates have serious health consequences for both individuals and communities; there are 30 percent more preventable hospitalizations for “ambulatory, care-sensitive conditions” for Medicare enrollees in the 12-state bloc than in the other 38 states, the report said.

“It’s tragic [in a] nation with these resources financially – medical resources, technology resources, et cetera – that we have a part of the country [where] 66 million people live … that looks more like Brazil or Bangladesh or the Philippines than the United States of America, and that’s just wrong,” says Truth Initiative CEO and President Robin Koval.

These states have a couple of other things in common — most of them have no statewide smoking ban and most of them have low cigarette taxes. Michigan and Ohio are the only two states in that swath that have indoor smoking bans.

This graphic shows the average state cigarette tax in those states is just 98 cents a pack, roughly half of the $1.89 a pack in the other 38 states.

It also isn’t a coincidence that most of these states are conservative and vote heavily Republican. Republican legislatures tend to be more averse to taxes and regulation, so you see no statewide smoking bans and low cigarette taxes.

And you also see a very high lung cancer rate in all of these states.

And there is also a lot of tobacco growing in that region, with millions of tobacco dollars contributed to political candidates. To keep those taxes low and keep those regulations away.

It’s something to celebrate the truly impressive inroads that have been made against smoking in the past 10 years. Both the adult and teen smoking rates have plummeted, the majority of states and major cities in the country have smoking bans, cigarette taxes have gone up and lung cancer deaths are going down. But, that’s sobered by the reality that one part of the country is being left behind by all these advances. People there are being betrayed by the people they’re voting into office.

Anyway, here is a link to a very cool interactive map where you can click on each state to see its smoking rate.